Individual
MR. GLENN F TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
17620 80TH AVE NE, APT# 302, KENMORE, WA 98028-6602
(425) 949-2617
Mailing address
17620 80TH AVE NE, APT# 302, KENMORE, WA 98028-6602
(425) 949-2617
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60172753
WA
Other
Enumeration date
01/05/2011
Last updated
01/05/2011
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